Individual
WILLAIM JASON FUGATE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
3980 DIXIE HWY, LOUISVILLE, KY 40216-4144
(502) 447-4232
Mailing address
3012 GROVEVIEW CT, LOUISVILLE, KY 40214-3971
(502) 813-1369
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
015557
KY
Other
Enumeration date
10/28/2011
Last updated
10/28/2011
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